Med Surg CARDIAC

Med Surg CARDIAC A nurse is reviewing self-care measures for a client with peripheral vascular disease. Which statement indicates proper self-care measures? A. "I like to soak my feet in the hot tub every day." B. "I walk only to the mailbox in my bare feet." C. "I stopped smoking and use only chewing tobacco." D. "I have my wife look at the soles of my feet each day." D. "I have my wife look at the soles of my feet each day." On a routine visir to the physician, a client with chronic arterial occlusive disease reports that he's stopeed smoking after 34 years. To relieve symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, which additional measue should the nurse recomend? A. Taking daily walks B. Engaging in anerobic exercise. C. Reducing daily fat intake to less than 45% of total calories. D. Abstaining from foods that increase levels of high-density lipoprotiends (HDL's) A. Taking daily walks A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement? A. "I sleep on three pillows each night." B. "My feet are bigger than normal." C. "My pants don't fit around my waist." D. "I don't have the same appetite I used to." A. "I sleep on three pillows each night." A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure? A. Platelet count B. Potassium C. Calcium D. White blood cell count (WBC) B. Potassium In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure? A. Cyanosis of the lips B. Bilateral crackles C. Productive cough D. Leg edema D. Leg edema A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation & relieve dyspnea, the nurse should: A. Administer oxygen B. Have the client take deep breaths & cough. C. Place the client in high fowlers position D. Perform chest physiotherapy C. Place the client in high fowlers position A 55-year-old black male is found to have a blood pressure of 150/90 mmHg during a work-site health screening. What should the nurse do? A. Consider this to be an abnormal finding for his age and race. B. Recommend he have his blood pressure checked in 1 year. C. Recommend he have his blood pressure rechecked within 2 weeks. D. Recommend he see his physician immediately for further evaluation. C. Recommend he have his blood pressure rechecked within 2 weeks. A nurse is caring for a client who has hypertension & diabetes mellitus. The clients blood pressure this morning was 150/92 mmHg. He asks the nurse what his blood pressure should be. The nurses most appropriate response is: A. "your blood pressure is fine. Just keep doing what you're doing." B. "The current recommendation is for everyone to have blood pressure of 140/90 mmHg or lower." C. "The lower the better. Blood pressure of 120/80 mmHg is best for everyone." D. "Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mmHg." D. "Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mmHg." The area of the heart that is located at the third IC space to the left of the sternum is the: A. Aortic area B. Pulmonic area C. Erbs point D. Epigastric area C. Erbs point The patient with cardiac failure is taught to report which of the following symptoms to the physicain or clinic immediately? A. Increased appetite B. Persistant cough C. Weight loss D. Ability to sleep through the night B. Persistant cough A client with heart failure must be monitored closely after starting diuretic therapy. The best indicator for the nurse to monitor is: A. Fluid intake and output B. Urine specific gravity C. Vital signs D. Weight D. Weight The nurse is reviewing the laboratory results for a patient having a suspected myocardial infarction (MI). What biomarkers should the nurse observe for myocardial cell damage? Select all that apply: A. Alkaline Phosphatase B. Creatine Kinase MB C. Creatine Kinase MM D. Troponin I B. Creatine Kinase MB D. Troponin I Upgrade to remove ads Only $3.99/month The nurse is providing teaching to a 33 year-old female patient about lovastatin for lowering cholesterol. What should the nurse include in the teaching? A. Monitor liver funtion tests (LFTs) B. Take the medication early in the morning on an empty stomach. C. Becoming pregnant while taking this medication is not a concern D. You no longer need to follow any dietary restrictions now that you are taking this medication. A. Monitor liver funtion tests (LFTs) A nurse is providing teaching to a client who is about to start taking Captopril. Which of the following instructions should the nurse include? A. Eat a meal before taking the medication B. This medication is safe to take during pregnancy C. Count your pulse rate before taking the medication D. Do not use salt substitute while taking this medication. D. Do not use salt substitute while taking this medication. The nurse is auscultating a clients heart sounds and notes a murmur at the left fourth intercostal space and lateral to the sternum. At which cardiac valve should the nurse document this murmur? A. Aortic valve B. Mitral valve C. Pulmonic valve D. Tricuspid valve D. Tricuspid valve Which of the following nursing assessment findings are suggestive of increased risk for coronary artery disease? Select all that apply: A. Arcus senilis B. Pear-shaped body C. Plump ears D. Hairless feet E. Motor changes A. Arcus senilis D. Hairless feet A patient has digoxin prescribed. The nurse should monitor for digoxin toxicity if which of the following occurs? A. The patient is also taking an ACE inhibitor B. The patient has hypokalemia C. The patient has a history of hypertension D. The patient has asthma B. The patient has hypokalemia The nurse should teach the patient that which of the following lab tests should be high to reduce the risk of heart disease? A. Total cholesterol B. LDL C. HDL D. Triglycerides C. HDL A patient has been given an overdose of heparin. Which medication should the nurse expect to administer? A. Warfarin B. Enoxaparin C. Lovastatin D. Protamine D. Protamine A patient is receiving a continuous intravenous infusion of heparin. What interventions should the nurse include? Select all that apply: A. Monitor the PT/INR every six hours B. Monitor the potassium level frequently C. Monitor the PTT every six hours D. Place the medication on an infusion pump E. Keep the patient on bedrest C. Monitor the PTT every six hours D. Place the medication on an infusion pump If the nurse is unable to palpate a patient's dorsalis pulse, what should the nurse do? Select all that apply: A. Palpate the pulses proximal to the dorsalis pedis B. Increase the circulation by ambulating the patient C. Check the dorsalis pedis pulse in the opposite foot D. Check the absent dorsalis pedis pulse with a doppler E. Elevate the limb for 6 hours and then check the pulse again. A. Palpate the pulses proximal to the dorsalis pedis C. Check the dorsalis pedis pulse in the opposite foot D. Check the absent dorsalis pedis pulse with a doppler A nurse is caring for a client who just had a cardiac catheterization via the femoral artery. Which nursing interventions should the nurse include in the clients plan of care for the first 8 hrs after the procedure? (Select all that apply.) A. Have the client remain in bed for at least 6 hrs. B. Keep the clients hip and leg extended C. Measure the clients vital signs every 4 hrs D. Place the client in high fowlers position E. Check peripheral pulses in the affected extremity. A. Have the client remain in bed for at least 6 hrs. B. Keep the clients hip and leg extended E. Check peripheral pulses in the affected extremity. Upgrade to remove ads Only $3.99/month A client comes to the Emergency Department via ambulance to report severe radiating chest pain and shortness of breath. The client appears restless, frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4 L/min stat, Cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following actions should the nurse take FIRST? A. Initiate oxygen therapy B. Insert the IV catheter C. Obtain the blood sample D. Attach the leads for a 12-lead ECG. A. Initiate oxygen therapy To evaluate a client following a coronary angiogram with a left antecubital insertion site, the nurse should do which of the following? A. Palpate the radial pulse in the right arm B. Palpate the radial pulse in the left arm C. Palpate the brachial pulse in the right arm D. Palpate the brachial pulse in the left arm B. Palpate the radial pulse in the left arm A nurse is providing teaching for a client who has a new diagnosis of stable angina pectoris. The nurse should teach the client which of the following information about anginal pain? A. The pain usually lasts more than 20 minutes B. The pain never radiates to the jaw or the back C. The pain persists with rest and organic nitrates D. Exertion and anxiety can trigger the pain. D. Exertion and anxiety can trigger the pain. A nurse is teaching a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat) sublingual tablets. The nurse evaluates that the client understands the teaching when the client states which of the following? A. "I'll dial 911 if one tablet does not relieve my pain" B. "I'll dial 911 when I have pain and then take the Nitroglycerin tablets." C. "I'll dial 911 if I still have pain after taking 3 tablets 5 minutes apart." D. "I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period." C. "I'll dial 911 if I still have pain after taking 3 tablets 5 minutes apart." A nurse on a medical unit is caring for a client who has angina pectoris and reports chest pain with a severity of 6 on a 0-10 scale. The nurse administers a sublingual nitroglycerin. After 5 minutes, the client states that his pain is now a 2 on a 0-10 scale. Which of the following actions should the nurse take? A. Administer another nitroglycerin tablet. B. Measure the clients arterial blood gases. C. Check the clients radial pulse D. Obtain an ECG A. Administer another nitroglycerin tablet. A nurse in the emergency department is caring for a client who has acute heart failure. Which laboratory value is MOST important for the nurse to check before administering medications to treat heart failure? A. Calcium B. Potassium C. Platelet count D. White blood cell (WBC) count B. Potassium The nurse is providing discharge education to a patient diagnosed with heart failure. What should the nurse teach this patient to do to assess fluid balance in the home setting? A. Monitor and record BP daily B. Monitor and record bowel movements C. Monitor and record radial pulses daily D. Monitor and record daily weight D. Monitor and record daily weight A patient has been diagnosed with congestive heart failure (CHF). The physician has ordered a medication to enhance contractility. The nurse should expect which medication to be ordered for the patient? A. Heparin B. Digoxin (Lanoxin) C. Clopidogrel (Plavix) D. Enoxaparin (Lovenox) B. Digoxin (Lanoxin) A nurse is providing care for a client who has a DVT and has been taking unfractionated heparin for 1 week. Two days ago, the provider also prescribed warfarin (coumadin). The client questions the nurse about receiving both heparin and warfarin at the same time. Which of the following is an appropriate response by the nurse? A. "Only one of these medications is being given to treat your DVT." B. "I will remind your provider that you are already receiving heparin." C. Laboratory findings indicated that 2 anticoagulants were needed." D. "I'll hold your heparin until we can clarify the order with your provider." E. "It takes 3 or 4 days before the effects of warfarin are achieved, then the heparin can be discontinued." E. "It takes 3 or 4 days before the effects of warfarin are achieved, then the heparin can be discontinued." A nurse who works in a busy emergency department is providing care for numerous patients who present with complaints of chest pain. Which of the following questions is most likely to help the nurse differentiate between chest pain that is attributable to angina and chest pain due to MI? A. "Does resting & remaining still help your chest pain decrease?" B. "Have you ever been diagnosed with high blood pressure or diabetes?" C. "When was the first time that you recall having chest pain?" D. "Does your chest pain make it difficult to move around like you normally would?" A. "Does resting & remaining still help your chest pain decrease?" The nursing instructor is talking about MI's to her junior nursing class. What should the instructor tell the students is the most common cause of an MI? A. Stroke B. Arteriosclerosis C. Venous stasis D. Coronary thrombosis D. Coronary thrombosis The student nurse is preparing a teaching plan for a patient being discharged status post MI. What should the Student include in the teaching plan? Select all that apply: A. Need for careful monitoring for cardiac symptoms B. Need for carefully regulated exercise C. Need for immediate resumption of prediagnosis activity D. Need for increased fluid intake E. Need for dietary modifications A. Need for careful monitoring for cardiac symptoms B. Need for carefully regulated exercise E. Need for dietary modifications A nurse is providing care for a client who experienced an MI. The client is prescribed propranolol. The nurse should understand that the therapeutic effect of this medication is which of the following? A. Decreases cholesterol level B. Increases cardiac output C. Decreases platelet aggregation D. Decreases resting heart rate D. Decreases resting heart rate A nurse is caring for a client who has HTN and is prescribed propranolol. While reviewing the client's health history, which of the following findings would cause the nurse to question the prescription? A. Angina B. Hypothyroidism C. Bronchial asthma D. Migraine headaches C. Bronchial asthma A nurse is screening a client for hypertension. Which of the following actions by the client increases the risk for hypertension? Select all that apply. A. Drinking eight ounces of nonfat milk daily B. Eating popcorn at the movie theater C. Walking one mile daily. D. Consuming 36 ounces of beer daily E. Getting a massage once a week B. Eating popcorn at the movie theater D. Consuming 36 ounces of beer daily A nurse is teaching a client who has a new prescription for warfarin prescribed for DVT. Which of the following should be included in the teaching? Select all that apply: A. Effects may not be apparent for several weeks. B. Advise the client to monitor for the presence of black, tarry stools. C. Advise the client to schedule a protime (PT) test. D. Advise the client that intake of foods containing vitamin K should be consistant. E. Advise the client to use over the counter aspirin & NSAIDS for mild pain. B. Advise the client to monitor for the presence of black, tarry stools. C. Advise the client to schedule a protime (PT) test. D. Advise the client that intake of foods containing vitamin K should be consistant. A nurse is providing care for a client who has a DVT and has been taking unfractionated heparin for 1 week. Two days ago, the provider also prescribed warfarin (coumadin). The client questions the nurse about receiving both heparin and warfarin at the same time. Which of the following is an appropriate response by the nurse? A. "Only one of these medications is being given to treat your DVT." B. "I will remind your provider that you are already receiving heparin." C. Laboratory findings indicated that 2 anticoagulants were needed." D. "I'll hold your heparin until we can clarify the order with your provider." E. "It takes 3 or 4 days before the effects of warfarin are achieved, then the heparin can be discontinued." E. "It takes 3 or 4 days before the effects of warfarin are achieved, then the heparin can be discontinued." A nurse in an urgent care clinic is obtaining a history from a client who has type 2 diabetes mellitus and a recent diagnosis of hypertension. This is the second time in 2 weeks that the client experienced hypoglycemia. The nurse should place the highest priority on reporting which of the following client data to the provider? A. Takes psyllium daily as a fiber laxative B. Drinks skim milk daily as a bedtime snack C. Takes a beta blocker daily after meals D. Drinks grapefruit juice daily with breakfast. C. Takes a beta blocker daily after meals The nurse is caring for a patient in the ED who has a B-type natiuretic peptide (BNP) level of 315 pg/mL. The nurse understands that this finding is most suggestive of which of the following? A. Heart failure B. Pulmonary edema C. Myocardial infarction D. Ventricular hypertrophy A. Heart failure The nurse is reviewing the laboratory results for a patient having a suspected MI. What biomarkers does the nurse observe for myocardial cell damage? Select all that apply: A. Alkaline phosphatase B. Creatine Kinase MB C. Creatine Kinase MM D. Troponin I B. Creatine Kinase MB D. Troponin I Upgrade to remove ads Only $3.99/month Shortly after being admitted to the coronary care unit with an acute MI, a client reports midsternal chest pain radiating down his left arm. The nurse notes that the client is restless and slightly diaphoretic, and measures a temperature of 99.6; a heart rate of 102 bpm; regular, slightly labored respirations at 26 breaths/minute; and a BP of 150/90 mmhg. Which nursing diagnosis takes HIGHEST priorty? A. Risk for imbalanced body temperature B. Decreased cardiac output C. Anxiety D. Acute pain D. Acute pain A nurse is providing discharge teaching for a client who has a new diagnosis of HTN and a prescription for furosemide (Lasix) 40 mg PO daily. What time of day should the nurse encourage the client to take the medication? A. Immediately before dinner B. Immediately after lunch C. At bedtime D. Morning D. Morning A nurse is providing discharge teaching for a client who has a new diagnosis of hypertension and a prescription for triamterene (Dyrenium) 50 mg PO daily. Which of the following statements by the client indicates a need for further teaching? A. "I will report any changes in heart rate or rhythm." B. "I should use a salt substitute that does not contain potassium." C. "I will continue to take this medication even if I am feeling better." D. "I should eat a lot of bananas and potatoes." D. "I should eat a lot of bananas and potatoes." A nurse is providing care for a client who has chronic venous insufficiency. The provider prescribed thigh high compression stockings. The nurse should instruct the client to do which of the following? A. Massage both legs firmly with lotion prior to applying the stockings B. Apply the stockings in the morning upon awakening & before getting out of bed. C. Roll the stockings down to the knees if they will not stay up on the thigh. D. Remove the stockings while out of bed for 1 hr, 4 times a day to allow the legs to rest. E. Wear the stockings only when in bed. B. Apply the stockings in the morning upon awakening & before getting out of bed. A nurse is teaching a client who has a new prescription for clopidogrel (Plavix) prescribed after a stent placement in the cath lab. Which of the following should be included in the teaching? Select all that apply: A. Effects may not be apparent for several weeks. B. Monitor for the presence of black, tarry stools. C. Schedule a weekly protime (PT) test. D. Advise the client to avoid foods containing vitamin K. E. Avoid using over the counter aspirin & NSAIDS. A. Effects may not be apparent for several weeks. B. Monitor for the presence of black, tarry stools. E. Avoid using over the counter aspirin & NSAIDS. The nurse is providing teaching to a client who has a diagnosis of DVT. To reduce the risk of a reoccurrence of DVT, the nurse should include information about which of the following? A. Avoiding stasis of blood flow B. Avoiding injury to the vessel wall C. Avoiding high-fat foods D. Avoiding increased blood coagulability E. Avoiding cigarette smoking A. Avoiding stasis of blood flow B. Avoiding injury to the vessel wall D. Avoiding increased blood coagulability